Exercise (Exertion) Headache

Reviewed by: HU Medical Review Board | Last reviewed: October 2020

Exercise or exertion headache is a headache triggered by physical activity or exercise. It may also be called a physical activity headache. Between 1 and 26 percent of adults get this type of headache, though it usually does not strike often.1

How long do exertion headaches last?

Exercise or exertion headache is felt on both sides of the head and pulses. It may last from 5 minutes to 2 days. It is more likely to happen in hot weather, high humidity, or at high altitudes but may happen in any kind of weather or altitude. Most people find their exertion headaches last 3 to 6 months and then go away.2

Older names for this type of headache include primary exertional headache and benign exertional headache.3

What causes exertion headaches?

Exertion headache is brought on by exercise or other strenuous activities. The head pain usually begins during or right after the activity and typically lasts less than 2 days. Most doctors believe changes in the blood vessels of the brain cause exertion headache.3

People who have migraine, or a family history of migraine, are more likely to have exertion headaches.

Exercise headache triggers

Exercise or exertion headache may be triggered by any strenuous exertion or physical activity such as:4

  • Weightlifting
  • Playing tennis
  • Running, especially long distances
  • Rowing
  • Swimming
  • Scuba diving
  • Coughing
  • Sexual activity

Diagnosing exertion headache

The International Headache Society defines exercise or exertion headache as:3

  • A pulsing or throbbing headache
  • Pain lasts between 5 minutes and 2 days
  • Brought on by and only happens during or after physical exertion

It is important to see a doctor the first time an exertion headache appears. Most exercise headaches are not a sign of serious illness, but your doctor will want to rule out conditions such as migraine, brain tumor, brain hemorrhage, or a tear in the arteries in the head or neck.2

Treating exertion headache

Avoiding strenuous exercise is one of the key treatment options for people who get exertion headaches. This is because most people only have these headaches for a certain period of time, usually 3 to 6 months. After that, most people can return to their normal activities.2

If the headache is mild or builds slowly, then your doctor may recommend you warm up slowly or join in less intense exercise for a few months. Some people find that taking a pain reliever or a beta-blocker about 1 hour before exercise helps prevent the headache or reduces its intensity.2

Any treatments for exertion headache should be stopped after 6 months to see if treatment is still needed.2

Migraine community experiences

Migraine.com advocates frequently write about their varying migraine triggers, including exercise. Often, people living with migraine can be on the receiving end of unsolicited advice, such as, “You should exercise more!”

There is much discussion over whether or not exercise helps or hurts those with migraine. In the 2018 Migraine In America survey, people were asked “What else, if anything, do you use on a regular basis to treat migraine and/or its symptoms?” Out of more than 4,000 respondents, 8 out of 10 said they used alternative therapies, including forms of exercise, to treat their migraine.

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